CAR-T Therapy

The information contained in these regimens is a statement of consensus of NCCP and ISMO or IHS professionals regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult these documents is expected to use independent medical judgement in the context of individual clinical circumstances to determine any patient's care or treatment. The treatment regimen to be used should take into account factors such as histology, molecular pathology, age, performance status, co-morbidities and the patient’s preference. Each treatment regimen has advantages and disadvantages, and there may be more than one good option.  In addition, treatment choices can change over time as more evidence becomes available. Use of these documents is the responsibility of the prescribing clinician and is subject to the HSE.ie terms of use.

Please email any comments or feedback on these regimens to oncologydrugs@cancercontrol.ie

CAR-T Therapy

Regimen Name Indication

Axicabtagene ciloleucel (Yescarta®) (CAR-T) DLBCL and PMBCL

Regimen

00717a

Treatment of adult patients with relapsed or refractory diffuse large B cell lymphoma (DLBCL) and primary mediastinal large B cell lymphoma (PMBCL), after two or more lines of systemic therapy.

00717b

For the treatment of adult patients with diffuse large B‑cell lymphoma (DLBCL) and high-grade B-cell lymphoma (HGBL) that relapses within 12 months from completion of, or is refractory to, first-line chemoimmunotherapy.

Fludarabine & cycloPHOSphamide Lymphodepletion for Axicabtagene ciloleucel (Yescarta®)

Regimen

00608a

Lymphodepletion chemotherapy regimen pre-treatment for CAR-T therapy with axicabtagene ciloleucel (Yescarta®) in adult patients with relapsed or refractory diffuse large B cell lymphoma (DLBCL) and primary mediastinal large B cell lymphoma (PMBCL), after two or more lines of systemic therapy.

00608b

Lymphodepletion chemotherapy regimen pre-treatment for CAR-T therapy with axicabtagene ciloleucel (Yescarta®) in adult patients with diffuse large B-cell lymphoma (DLBCL) and high-grade B-cell lymphoma (HGBL) that relapses within 12 months from completion of, or is refractory to, first-line chemoimmunotherapy.

Brexucabtagene Autoleucel (Tecartus®) (CAR-T) B-cell ALL

Regimen

00898a

 For the treatment of adult patients 26 years of age and above with relapsed or refractory B-cell precursor acute lymphoblastic leukaemia (ALL)

Fludarabine & cycloPHOSphamide Lymphodepletion for Brexucabtagene Autoleucel (Tecartus®) B-cell ALL

Regimen

00899a

Lymphodepletion chemotherapy regimen pre-treatment for CAR-T therapy brexucabtagene autoleucel (Tecartus®) in adult patients 26 years of age and above with relapsed or refractory B-cell precursor acute lymphoblastic leukaemia (ALL)

Ciltacabtagene Autoleucel (Carvykti®) Multiple Myeloma

Regimen

00835a

For the treatment of adult patients with relapsed or refractory multiple myeloma, who have received at least three prior therapies, including an immunomodulatory agent, a proteasome inhibitor and an anti CD38 antibody and have demonstrated disease progression on the last therapy.

 Fludarabine & cycloPHOSphamide Lymphodepletion for Ciltacabtagene Autoleucel (Carvykti®) Multiple Myeloma Therapy

Regimen

 00836a

Lymphodepletion therapy regimen pre-treatment for CAR-T therapy with ciltacabtagene autoleucel (Carvykti®) in the treatment of adult patients with relapsed or refractory multiple myeloma, who have received at least three prior therapies, including an immunomodulatory agent, a proteasome inhibitor and an anti CD38 antibody and have demonstrated disease progression on the last therapy.

Fludarabine & cycloPHOSphamide Lymphodepletion for Tisagenlecleucel (Kymriah®) DLBCL

Regimen

00606a

Lymphodepletion chemotherapy regimen pre-treatment for CAR-T therapy Tisagenlecleucel (Kymriah®) in adult patients with relapsed or refractory DLBCL after two or more lines of systemic therapy

00606b

Lymphodepletion chemotherapy regimen pre-treatment for CAR-T therapy Tisagenlecleucel (Kymriah®) in adult patients with relapsed or refractory follicular lymphoma (FL) after two or more lines of systemic therapy.

Fludarabine & cycloPHOSphamide Lymphodepletion for Tisagenlecleucel (Kymriah®) B-cell ALL

Regimen

00607a

Lymphodepleting chemotherapy regimen pre-treatment for CAR-T therapy Tisagenlecleucel (Kymriah®) in adult patients aged 18-25 years with B-cell ALL that is refractory, in relapse post-transplant or in second or later relapse

Tisagenlecleucel (Kymriah®) (CAR-T) DLBCL and FL

Regimen

00687a

Treatment of adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) after two or more lines of systemic therapy

00687b

Treatment of adult patients with relapsed or refractory follicular lymphoma (FL) after two or more lines of systemic therapy.

Tisagenlecleucel (Kymriah®) (CAR-T) B-ALL

Regimen

00686a

Treatment of paediatric and young adult patients up to and including 25 years of age with B-cell acute lymphoblastic leukaemia (ALL) that is refractory, in relapse post-transplant or in second or later relapse